Fracture Management and Primary Care презентация

Description
A fracture is a disruption or break in the continuity of the structure of bone
The extent of damage to the fracture can be complete in which the bone is broken completely, and incomplete, when there is only a bone fracture or crack it.

On the basis of Etiology:
1.Traumatic fractures
Most commmon type of fractures
Road accidents, falls, fight, etc.
2.Pathological fractures
Bone made weak by some underlying disease
3.Stress fractures
Most stress fracturesare caused by overuse and repetitive activity, and are common in runners and athletes who participate in running sports, such as soccer and basketball.

Classification by Communication with
External Environment

On the basis of complexity of fractures:
Simple fractures
Complex fractures

On the basis of Pattern:
Transverse fracture
Oblique fracture
Spiral fracture
Comminuted fracture
Segmental fracture

On the basis of Displacements:
Undisplaced fracture
Displaced fracture

Signs of bone fractures
Strong swelling,
bruising,
sometimes the limb is bent outside the joint; with an open fracture,
the bone ends may protrude from the wound.
With casual movements, you can notice the abnormal movement of the limb in the place where there is no joint;
sometimes you hear the crunch from rubbing bone.

Closed Fractures
There are closed fractures in which skin integrity is not broken.

Treatment of fractures can be considered in 3 phases:
PHASE I: EMERGENCY CARE
PHASE II: DEFINITIVE CARE
PHASE III: REHBAILITATION

EMERGENCY CARE
At the site of Accident
RICE
Rest to the
part, by
Splinting
Ice therapy,
to reduce
occurence
of Swelling
Compression,
To reduce
Swelling
Elevation, to
Reduce
Swelling

Rest is done by “SPLINTING”
Purpose
Reduce pain
Reduce bleeding and swelling
Prevent further soft tissue damage
Prevent vascular constriction
What to splint
Fracture
Dislocation
Tendon rupture

Ice therapy
An immediate application of ice to the injured part reduces pain and swelling.
Done by taking crushed ice in a polythene bag, and covering it with a wet cloth, or simply commercially available ice pack can be used.
If any wound is present then it has to be covered with a sterile clean cloth.

Compression
A crepe bandage is applied over the injured part, making sure that it is not too tight.

Elevation
Limb is elevated so that the injured part is above the level of the heart.
Can be done using pillows or slings.

In the Emergency Department:

Open fractures
An open fracture can be defined as ‘a break in the skin and underlying soft tissue leading directly into, or communicating with, a fracture or its hematoma.
Estimated Annual frequency = 11.5 per 100,000

Results from high-energy trauma, often with extensive soft tissue injury and contamination.
Therefore, they carry a much higher rate of non-union, deep infection and implant failure than closed injuries.

Debride the wound
Stabilise the wound
Cover the defect

Bone Healing
Fig. 61-7